Ann Case and Angus Deaton’s Deaths of Despair is a depressing but important book. I have read parts of it but plan to read it from cover to cover soon. They document and analyze a substantial group of Americans, mostly whites without college degrees, who die from alcohol, narcotics, or suicide. Starting in the 1990s their numbers grew. Part of the problem for some of the despairing is having jobs that give them hope for a better future, jobs that at least allow them to securely start and raise a family.
The growth in narcotics use is thoughtfully described in an earlier book, Dreamland by Sam Quinones. In some of the book Quinones writes about the same non-degree despairing whites as Case and Deaton, but he also in other parts of the book, discusses rising narcotics use among the better-off. His is a thoughtful complex narrative, involving diverse victims and diverse causes.
One component is that, from desire for euphoria, or to end pain, people start using narcotics that are addictive. Then they must fight, or succumb to, the addiction for the rest of their lives. For those drawn in by a desire to end pain, the news in the passages quoted below is important–the approval of suzetrigine, a drug that blocks some kinds of pain without being addictive. Quinones in his 2015 book reports his conversation with an expert who was pessimistic that such a drug would ever be possible (pp. 311-312).
A second reason suzetrigine is of interest is that it is being brought to market by Vertex, a firm that I have discussed in earlier blog entries, most recently here. Vertex was a once-small innovative mission-oriented start-up that got big. The continuing question is whether the big Vertex can sustain its earlier innovative culture.
(p. A11) The Food and Drug Administration approved a new medication Thursday [Jan. 30, 2025] to treat pain from an injury or surgery. It is expensive, with a list price of $15.50 per pill. But unlike opioid pain medicines, it cannot become addictive.
That is because the drug, suzetrigine, made by Vertex Pharmaceuticals and to be sold as Journavx, works only on nerves outside the brain, blocking pain signals. It cannot get into the brain.
Researchers say they expect it to be the first of a new generation of more powerful nonaddictive drugs to relieve pain.
To test the drug, Vertex, which is based in Boston, conducted two large clinical trials, each with approximately 1,000 patients who had pain from surgery. They were randomly assigned to get a placebo; to get the opioid sold as Vicodin, a widely used combination pain medicine of acetaminophen (Tylenol) and hydrocodone; or to get suzetrigine.
. . .
Suzetrigine eased pain as much as the combination opioid. Both were better than the placebo at relieving pain.
For the full story see:
(Note: ellipsis, and bracketed date, added.)
(Note: the online version of the story has the date Jan. 30, 2025, and has the title “F.D.A. Approves Drug to Treat Pain Without Opioid Effects.”)
The Case and Deaton book, cited in my introductory comments, is:
Case, Anne, and Angus Deaton. Deaths of Despair and the Future of Capitalism. Princeton, N.J.: Princeton University Press, 2020. Reprint, pb 2021 (with new preface).
The Quinones book, cited in my introductory comments, is:
Quinones, Sam. Dreamland: The True Tale of America’s Opiate Epidemic. New York: Bloomsbury Press, 2015.